Showing posts with label anxiety. Show all posts
Showing posts with label anxiety. Show all posts

Sunday, December 30, 2012

One of the best decisions I made in 2012: antidepressants

I wish that eating well, running, and staying busy were enough to keep depression and anxiety at bay for me, but they aren't. Those are all things I've been doing for years, and still - for years - I had this constant, nagging feeling of Something is wrong with me. I planned my own funeral for fun. I wrote depressing entries in my diary. I made friends and lost them, over and over again. Something is wrong with me. I got angry and threw things. I cried while lying on the floor of the bathroom, light off, door locked. I quit things, changed jobs, viewed moving once every year or two as a perfectly logical approach to dealing with social discomfort. Something is wrong with me.

And yet throughout that time, I looked totally functional to most people. I went to school or work. I excelled in classes and in my jobs. I smiled, bantered, was personable. I maintained my relationship with my husband. I had a kid.

Few people outside my immediate family knew how much I was struggling. I didn't know how much I was struggling. Periodic bouts of exhaustion, near-constant irritability, and daily anxiety attacks were, from my perspective, just part of the fabric of my personality. And to a certain degree, one gets used to feeling bad when one has felt that way since her early teens. I had enough coping strategies in place (like working really hard, eating well, running, sleeping, zoning out, distancing myself from others if I might go all Jekyll-and-Hyde on them, etc.) that I got by, for the most part. As the years went on I also became adept at hiding what was really going on.

That's a common theme in mental health: hiding. Which is partly why so many of us who struggle with difficult mental experiences feel so isolated and alone. We don't want to embarrass ourselves, so we compensate by striving to look normal (or better yet, GREAT!); when we do furtively glance over the wall to see if there's anyone else out there, the place looks empty. In reality the mental health landscape is full of people struggling with similar things, all hiding from one another, afraid (often understandably so) to stand up and put it all out there. I think that's slowly changing. Finally.

I started therapy long before I started taking an antidepressant, a strategy that now seems somewhat backwards. Don't get me wrong: therapy has been invaluable in that it's offered a place where I can dig through my life and identify where, how, and why ineffective habits developed. It's given me tools: I've learned how to set boundaries, be nice to myself, combat negative thoughts, handle conflict, and be more assertive. I needed the therapy; it was one of the best decisions I have ever made. The problem was, implementing these strategies while dealing with full-on depression and anxiety was like trying to build a life raft while in the active process of drowning. 

Only after I got in touch with a psychiatrist, received a diagnosis (major depression and PTSD), and started on Zoloft (a relatively reliable, long-studied antidepressant used specifically to treat PTSD, among other conditions) did I realize just how long I'd been on the verge of being pulled under permanently. I'd gotten so used to treading water that I didn't know life's not supposed to be a constant day-to-day, year-to-year struggle. I did recognize that the bad times were growing progressively worse. By last January I was having the conversation with my therapist of, "I won't end my life. But I think about it. But I won't do it. But sometimes I want to just not exist," and him saying, "What you're holding onto is an emergency exit option. As long as that door is open, even just a little, you are in danger."

It's hard to describe how different my life is now that I am taking that little white pill every morning. Maybe it looks the same from the outside. I'm still doing what I've always done: working hard, running, putting time and effort into my relationships, challenging myself. But from the inside, it's like Extreme Makeover: Headspace Edition. My anxiety is still there, but I'm mostly able to manage it. I still get depressed, but I recognize the warning signs and know to take action before things get really bad. And all the techniques from therapy? Now I can actually put them into practice on a consistent basis. (Turns out, positive self-talk really works, if you can make yourself do it!)

Sometimes it's hard to remember what it used to be like. I do find myself wondering why I couldn't pull it together, why I made things so hard for myself. But then I'll read an old journal entry or think back to one of my earlier sessions in therapy, and I'll remember that I didn't do this to myself, that I was working as hard as I possibly could to fix my brain. I couldn't save myself no matter how much CBT, EMDR, or western meditation I did. A person with two broken arms might know everything about what it takes to construct a house; she might have all the tools, all the blueprints. But unless her broken arms are set and have a chance to heal, there's no way she's going to be able to actively use her arms to build it.

That's what medicine has done for me: it's put me in a place where my brain can rest long enough to (hopefully) get better. Sometimes I do wonder whether I will ever be able to stop taking Zoloft. Part of me believes it's just a temporary support beam, and that if I can just use this time to reconstruct and galvanize my way of thinking, I'll eventually be able to remove that support. Another part of me worries that if I ever stop, the whole thing will collapse. At any rate, I'm not ready to quit medication just yet. It's working for me; if it's working, why stop? The statistics also give me pause. Depression is one of those things where if you experience it a couple of times, you're likely to experience it again in the future, and it might be worse the next time.

Of course, every person's experiences are unique, and that's certainly true when it comes to antidepressants. I've read that for some people, they don't work; some people have side effects that negate the positive outcomes; other people do well on them for awhile, and then the medication loses its effectiveness. For all I know, Zoloft might lose its oomph for me, too. But for now, I'm just grateful that it's working. It's one of the best - perhaps the best - decision I made this year.

Thursday, August 9, 2012

The best-laid plans...

Treadmill workout - 1 hour of intervals at 2% incline:

  • 5 minutes of walking
  • 6 x walking/running intervals: 2 minutes walking, 2 minutes running at ~10K pace; increase speed by .1 each time (total of 24 minutes)
  • 6 x walking/running intervals: 2 minutes walking, 3 minutes running at ~10K pace; increase speed by .1 each time (total of 30 minutes)
  • ~2 minutes walking to cool down

I like intervals on the treadmill because they break up the monotony a bit. Today's workout was challenging - I felt tired and blah, but I was glad I did it anyway.

On a different note, I'm feeling frustrated tonight - at myself and at others. I try to establish limits in terms of letting people know what I can and can't do. I try to set myself up for success in terms of scheduling so that I won't get stressed out. In the past, I haven't been too good about that. I overwork and overbook myself, and the outcome is never good. At least three times this year so far, overdoing it has brought me to a miserable and scary place.

I'm working hard to get better at handling stress, but it is a long road to improvement. Stress is my kryptonite.

I made a huge effort to limit my obligations this fall so that I could focus on just two or three key tasks and keep stress at bay. Today I found out that, through absolutely no choice of my own and due to poor planning on the part of others, I'm getting a lot more on my plate. It's very last minute. Had I known this was going to happen, I would have arranged the fall semester in a much different way. I expressed my concern about it and was basically told that I'm just going to have to deal with it.

I'm worried and kind of scared about what this will mean re: stress. I'm mad because the person who's responsible for overturning my plans knows about all of the mental health stuff but doesn't seem to believe me. He sees me show up every day, get my work done, and do it well, and he assumes that surely everything is fine. He has absolutely no idea. Sometimes I am at my most productive when I am at my lowest: it's like I split into 2+ people, and each person does their own task, and well. It's one of the things I tend to do when my brain goes into red alert mode. It works, but it's exhausting, and it means I'm not in a good place.

I don't want to make excuses. I don't want to shirk my responsibilities. But I want to have some room to set what I feel are necessary limits/boundaries without someone coming in and totally destroying them.

Wednesday, July 25, 2012

Family reunion (open bar)

Once I was done with labwork in Pullman, I drove over to Seattle for an impromptu family reunion of sorts. My brother lives there with his wife and son, and my parents flew in from the East Coast.

My brother has several bottles of wine and a case of beer on hand. Plus a full container of Jack Daniels in the fridge.

Being with my parents is difficult for me (and my brother, I think), for reasons that date back to when I was little. At our worst times, our visits have ended in fights suitable for the Jerry Springer Show (I remember being 10 weeks pregnant with my son and getting into an argument with my dad while we were in the car; at one point I was convinced he was going to plow right off the road, we were screaming so much). At best, we can eat dinner together, have a couple glasses of wine, and sit in the same room for a few hours. And even this feels something akin to running a marathon that I haven't adequately trained for.

Sometimes, when I hear about people going on pleasant vacations with their parents or having raucous Thanksgiving meals together or saying that their mom is their best friend or seeing their mom and dad over the weekend just to get that old comfort of home, I feel jealous. It's just not like that for us. The tension never goes away. There is so much unsaid and no-one is going to start that conversation. It would be way too difficult, way too painful.

One thing I have learned - thanks to my parents, but also to my husband and especially my son - is how influential and important family is. I mean, I knew that on an intellectual level, but now it's seeped into my bones. I truly believe there is nothing more important than raising a child as best you can, as lovingly and thoughtfully as you can, because that love (or lack thereof) is the foundation for everything that happens after. I say this as someone who wrestles with parenting on a daily basis. I am not a natural. But I am doing my damnedest to be "good enough" and to change what I need to change to be someone my son can count on.

"Whatever you are, whatever you do, your baby will get it. Anything you eat, any worries that are on your mind will be for him or her. Can you tell me that you cannot smile? Think of the baby, and smile for him, for her, for the future generations. Please don't tell me that a smile and your sorrow just don't go together. It's your sorrow, but what about your baby? It's not his sorrow, it's not her sorrow.” - Thich Nhat Hanh

Sunday, January 22, 2012

Cracking

Last week, two days before my paper critique presentation (the last step in the comprehensive exam process), I lost it.

I could feel it coming on - the exhaustion, the muddled thinking, the panic, the inability to get to sleep or stay asleep, the obsessive studying and note-taking (did I really need to write and re-write and re-write the four characteristics of a geographic information system?) - and I knew there would be consequences, but I kept thinking that I just needed to shove all that aside, pull myself together, and get through the presentation. And I almost made it. I almost managed to plow through before I lost my mental cookies.

And then Tuesday came along, and someone said just the wrong thing, and I came to a screeching halt. I felt so low, so depressed, so anxious, and so very out of it. I can't really explain it - I felt utterly detached from reality and unable to ground myself. Everything seemed so loud and looked so dim. I came home from school that day and went straight to bed, where I cried for three hours. Then I wrote to my advisor and said that I was struggling. Then I proceeded to not fall asleep for a while, and then I woke up at 3 a.m. and couldn't get back to sleep. All the while knowing that I needed to have a polished written critique submitted to my committee by 5 p.m. Wednesday, and a polished 20-minute presentation ready to deliver by 1 p.m. on Thursday.

On Wednesday morning, I dragged myself to my old therapist's office. I had bags under my eyes and I wasn't thinking clearly. I was dizzy. I kept spacing out; he kept asking me how present I was and reminding me to stay with him. I told him that I felt like I was really, truly on the verge of a breakdown and that the thought of continuing to live with these mood swings - as I have for most of my life so far - was unbearable. I told him that sometimes the thought of death was so nice. Not that I would ever do anything to myself - I wouldn't, because I wouldn't do that to my son; I wouldn't ruin his life - but for as long as I can remember, when things get bad it's comforting to think of not being here. I remember being 13 years old and obsessively planning my funeral, just because it helped calm me down. But this time I was scared, because I was so very out of it and I had such a tenuous handle on... everything.

When the hour was up he did the typical "Well, it looks like we're out of time" therapist thing, but when I stood up to leave and fumbled through my wallet for the check, he hesitated and said we had a couple more minutes. I sat down again, and he gave me some suggestions - one of which was to go to the student counseling center and talk to them about medication. I have tried hard to avoid medication for reasons I don't totally understand. Perhaps it's a control thing. Perhaps it's a fear that the medicine won't work, and then what will I do? What will my options be? Perhaps it's the worry that the medicine will work for a while, and then it will stop.

But this time I think I'm ready to try it. What happened last week truly terrified me. It's not like comprehensive exams were the scariest thing in the world, nor should they have been as stressful as I managed to make them. I think they were just the straw that broke the camel's back... Between that, and my mom getting sick, and traveling last month, and having this cold that won't go away, plus all of the other things that are always running obsessively through my head anyway, plus what just may be chemical issues in my brain that I can't control, I shut down. I broke.

So in two weeks I have an appointment with a psychiatrist. I know that by then I may be feeling fine. I may have forgotten what I felt like a few days ago (and what I still feel like, a little - these episodes leave an emotional residue). But regardless, I'm doing it anyway, and I'm going to make sure the doctor understands that despite my placid and friendly-looking exterior, I need some help.

One of my friends sent me a link to a blog entry about a guy who was afraid to go on medication but found that it made a real difference for him. It's a Christian blog, and I'm not a Christian, but it was moving and helpful and comforting anyway:

http://www.air1.com/blog/brant/post/2012/01/10/Is-Jesus-Enough.aspx

I especially relate to this - this feeling that I can't rest, I can't make my mind stop, I'm a failure, life is rushing by and I can never quite catch it: "My life had been wasted. I'd accomplished nothing, and the sorrow of it all was descending on me. The vanished years! I've done nothing! Where did the time go? Life is too fast, rushing by like a freight train, and I couldn't get on it... I'd previously lie there and think about how I blew it on the air this morning; how I never should have quit talk radio; how I shouldn't have said that one awkward thing five, 10, or 25 years ago;  how I'd wasted whatever I'd been given; how I'd failed to provide a yard for my kids to play in; how the years were slipping by, and, though my wife said differently, I just knew I wasn't doing enough as a dad or a husband or a child of God."

In the two years that I have known my therapist, he has never recommended medication. I'm not sure that's really his thing. He has recommended talking, meditation, yoga, tai chi, and rest. He has recommended opening up to other people and taking some risks in order to develop friendships. He has recommended relying on my family when things get tough. He has recommended that I call him if I need to, even if it is 11 p.m. on a Saturday night (he doesn't mind and he will call me back, he says). But the other day, I think he could see that I have kind of hit my limit. I think he could see how scared I was and how tired I was - of myself.

I did get through the critique, by the way. After my therapy session I came home and slept for two hours. Then I hauled myself out of bed, somehow wrote something that my advisor said was thoughtful and comprehensive, and put together a presentation that, while not an oratory masterpiece, served its purpose. In all honesty, I have no idea how I did it. I really don't. I'm just glad it's over.

Saturday, November 5, 2011

Saturday morning

Saturday morning means...

...long, long runs for my husband (20 miles today).

...dark coffee with sugar and almond milk (often reheated a time or two in the microwave because I drink it so slowly)...


...a messy, messy family room, strewn with Legos and trains and books and balloons...


...sweatpants, sweatshirts, and warm socks...


...and me trying to relax, with varying degrees of success. It depends on the weekend. I always take Saturday off, but sometimes my mind continues to whirl even as I'm doing all of the things that supposedly constitute a lazy weekend.

I can tell my anxiety levels are higher than they were, say, a month ago. When I get anxious, I tend to fixate on things and become intensely self-critical. Right now, for instance, I can't seem to stop thinking about a big poster presentation I need to prepare in the next few weeks. Is there any point in sitting here for hours, visualizing where I might place various pictures on said poster? No, but I'm doing just that. I also can't stop thinking that maybe grad school was a big mistake, maybe I'm not smart enough, maybe my advisors have realized I'm an idiot, maybe I'll finish and graduate and nothing will come of it, job-wise. This is the first time in the entire year and a half that I've been in this program that I've had such strong self-doubts... and for seemingly no good direct reason. Thus, I can only assume that stress in my personal life is manifesting itself in my professional life. Emotions are getting distorted and displaced. At times like this I try to ignore what the critical voice in my head is saying. I remind myself that in all likelihood, it is wrong.

From an objective standpoint, I can see that yes, I am stressed out and overwhelmed, and perhaps I've been less patient with certain people - but in the past week I've finished every assignment that was due and attended every meeting that was scheduled. I've taught my class and written lessons. I've gotten up every morning and gone to school. It's true that I am distracted, and it's true that maybe I'm not powering along as I usually do, but I know that if I were an advisor, I would be understanding of that. I have to assume that my own advisors (who are aware that my mom was just diagnosed with cancer and is in the hospital recovering from surgery) can see where I'm coming from and aren't holding it against me.

Around my family, I've been tired. I often come home, eat dinner, and then lay in bed for a little while (a pre-bed nap, if you will). It's not ideal, but I need that time to myself. After a few minutes, I feel somewhat re-energized and can interact with my husband and son without being a complete zombie. Right now I am not being the best partner or mother. I am being a "good enough" partner and mother.

It's hard for a perfectionist to accept "good enough."

*     *
Yesterday morning, I got up at 5 a.m. and ran four miles at a 10:30- to 10-minute-per-mile pace. That's faster than what I've been running, and I felt good. Tomorrow I'm scheduled to run 7 miles at a comfortable pace. I'm glad for the running. I need it. It's distracting, it's comforting, it's predictable, and it's a challenge that I know I can actually meet. Running is solace.

Friday, October 21, 2011

Social anxiety

I'm feeling a little frustrated with myself tonight, as I often do after I've attended a function with a lot of other people. I really like socializing. I like joking around, I like talking, I like listening.

But.

As much as I enjoy being around other people (in fact I think I really NEED that interaction), I struggle with social anxiety. My visions of what parties and other gatherings are going to be like, and how I'm going to feel in those situations, never seem to match up with what happens.

Here's what generally hampers my ability to relax in big groups:

1. Noise: If the room is noisy and I can't hear what the other person is saying, or if I can tell that they can't hear me, I get kind of zoned out. Noise gets to me.

2. Dissociation: I dissociate a lot - not when I'm on my own, but definitely a) in stressful moments or b) when I am around a lot of other people. When I dissociate, it's like I float off. I watch myself from a distance. My body is there, but my brain is elsewhere. I start to lose my words and have a hard time focusing. My husband says my eyes glaze over. I try very hard to stay grounded, and I'm definitely getting better at it - but tonight I felt it happening with almost every person I talked to. When I try to pull myself in, I start to feel crushed by the noise, by the gaze of whomever is watching me, etc.

3. Self-consciousness: Even if I start out with confidence, I usually leave the gathering feeling like I said all the wrong things... like I embarrassed myself... like no-one likes me because I'm such an awkward loser. And then I spend the next two days analyzing what happened. It almost makes attending these functions totally not worthwhile.

It was kind of a rough day anyway. A bunch of things happened at school that, while they would probably annoy me on even my best days, made me feel angry and frustrated. And when I feel angry/frustrated, everyone can tell. I wish I could hide those emotions, wipe them off my face. But my expressions make me an open book.

Wednesday, October 5, 2011

It's been a while...

My last blog post was in January. I stopped writing when things got too busy... and when things got too busy, I also stopped running on a regular basis. I hit the road or the treadmill maybe once or twice a week - that was it.

It was a rough spring. I've always had sporadic issues with depression and anxiety, but earlier this year they ramped up to a whole new level. I felt like I was drowning, like I couldn't breathe. I was tired all the time. I was lonely. At times, I felt nearly suicidal. The only thing that seemed to mitigate the symptoms was school, so I'd go in early in the morning, work nonstop until 5 or 6, and then drive home. My symptoms seemed to worsen in the evenings, on weekends, and whenever I had a break. Not ideal for the mother of a preschooler (and definitely not ideal for the preschooler). I did my best, but it was like trudging through taffy.

I saw a therapist every week. Therapy helped me work through some painful experiences and negative self-perceptions, but it was hard work. Sometimes I'd leave feeling much worse than when I walked in. Still, I slowly improved. I gained some valuable tools for coping with tough emotions. I learned to remind myself that "I won't always feel this bad. It will get better." A few weeks ago I decided I was ready to venture out again sans therapist. At my last session, I asked him to identify one thing that he thought would really, truly help me manage my moods. I thought he might recommend yoga, or meditation, or medication.

Instead, "Run. Run often. When you talk about running, it's clear that it's a positive thing for you. And enter races - compete. It'll give you something to shoot for and something other than school to focus on."

And so for the past 3 weeks I have been running nearly every day. I've tracked my feelings and my moods, and while the anxiety and sadness still crop up, they've lost their oomph and their edge. I feel better about myself and more confident around others. Challenges, obstacles, and criticism seem less daunting somehow. When I received some (what I felt were) unfair comments on a recent homework assignment, I didn't go home and cry the whole evening as I would have in the past. I felt disgruntled, and I thought, "That sucks. That's uncalled for," but then I went on with my day. It was just a blip. It was a small drop in the huge ocean of experience, a drop that became increasingly diluted until I forgot about it entirely.

In the past, I've always run for fitness or to work off extra calories. But now I want to run for my mental health. Like I said, I've always struggled with roller coaster moods and emotions, and I'm tired of it. I'm tired of feeling lousy. And I don't want to go through what I went through this past spring. It was just too scary. If running 5-6 days a week will give me a brighter outlook on life, then that's what I'm going to do.

So I'm going to start writing here again and logging my miles (still mostly on the treadmill), but I'm going to change my focus a bit. It's less about the distance and exercise now, and more about managing my emotional well-being. I want to see if I can tame my moods simply through exercise and healthy living.

I'm also planning to enter more races, as my therapist suggested. I recently ran a 6K, and this Saturday I'll be running in a 5K. I like short races. They don't require a ton of training, but with some effort I'm pretty sure I can improve my times. And I do enjoy being around other runners, feeling their energy, and moving together towards a common goal.

Monday, January 10, 2011

Pizza

Things I thought about today: the tragedy in Tucson, mental illness, snow, snow days (I did get one!). Potty training (my son is finally potty trained, as of today). Anxiety about the start of a new semester and all that it entails: classes, teaching, research, grant proposals, balancing work and parenting. The gnawing question of, When this is all over, will I have the job and career I want? Will I be good enough to have the job/career I want? Running three miles helped a lot... Sometimes I need all the endorphins I can get. They seem to subdue the negative self-commentary and the pointless questions.

I made a gluten-free pizza for dinner using the Bob's Red Mill mix and topped it with Muir Glen pizza sauce (YUM), shredded mozzarella, and onions. Personally, I really love the flavor, but the texture is distinct from, say, Dominoes or Tombstone or Mellow Mushroom. I've made this pizza for several of my gluten-eating friends, and while some of them have enjoyed it (or at least put up with it), others have had a less favorable impression. I must say, the gluten-y thing I miss the most is a giant slice of New York-style pizza pie.

Here's a picture of the finished product. It's not very pretty because we dove in and devoured it as soon as it was out of the oven:


Today's mileage: 3.2 miles
Weekly total: 7.3 miles
Cumulative total: 28.7 miles